‘I’m not listening to you!’ Interacting in a linguistically diverse society


Manus Island Detention Centre, where Faysal Ishak Ahmed collapsed (Source: ABC News)

On December 23, 2016, as most Australians were winding down for the holiday week ahead, Faysal Ishak Ahmed, a 27-year-old man from South Sudan died in immigration detention when he collapsed with a seizure. After his death, it emerged that the young man had repeatedly presented at the facility’s healthcare provider over a period of several months for a range of health issues such as stomach upsets, high blood pressure, fevers and heart problems. However, he never got to see a doctor and each time was dismissed by the nurse on duty. He described one such incident to his friends shortly before his death:

I went to the [healthcare provider] and then [they] told me that, hey you don’t have anything, you are not sick and you’re pretending to be sick, and from now on, we don’t want you to come down here, so please stop coming here. (Quoted from ABC News)

Even if rarely with fatal consequences as in Ahmed’s case, the experience of not being listened to and not being taken seriously is one that many people who speak English “with an accent” can relate to.

Cases such as these where patients with limited proficiency in the dominant language are not taken seriously and oftentimes simply ignored are not unique to Australia, as a US study of doctors and nurses working with patients with limited English proficiency demonstrates (Kenison et al., 2016). In a quote that has almost uncanny echoes of Faysal Ishak Ahmed’s experience on the other side of the world, one junior doctor reported this conversation with a senior clinician to the researchers:

And he said, ‘Oh, you know we see this, a lot of this Haitian chest pain.’ And I said, ‘What do you mean by that?’ And he said, ‘Well, they come in and the tests are negative, and they have a different perception of pain than other people.’ He kind of wrote it off that way. I felt a little weird that it was written off that quickly. To write off the chest pain on a patient who is having trouble communicating because she’s using a phone interpreter. (Kenison et al., 2016, p. 3)


Faysal Ishak Ahmed, who died after being dismissed by health care provider (Source: ABC News)

Most people assume that language proficiency is a specific skill set that a person has or does not have. It is further assumed that, once migrants have reached a particular level of English, they will be able to “integrate” and interact on a level playing field. This view of language proficiency as a property of the speaker is fundamentally mistaken because we don’t use language as isolated individuals. Language is a social tool and language proficiency is jointly constructed in interaction. To be able to form grammatically correct sentences does not necessarily translate into “the power to impose reception”, as sociologist Pierre Bourdieu has pointed out.

A wealth of sociolinguistic evidence demonstrates that non-standard speech, such as the English of multilinguals that shows traces of their non-English-speaking background (NESB), is rarely taken just as a specific way of speaking but as an index of a particular identity – often the identity of someone who is considered less worthy. Ahmed was assumed to be a fake patient. In our research with adult NESB migrants here at Macquarie University, we have met highly qualified job applicants whose skills were obscured by their accents; capable and diligent students who were considered lazy and poorly motivated on the basis of their English expression; or consumers who did not manage to return faulty products within the warranty period because shop assistants pretended not to understand them.

Mundane interactions such as these have broad social consequences. Far from interacting on a level playing field, NESB speakers have unequal opportunities to access employment, education, health care or community participation.

While we have become increasingly vigilant with regard to discrimination based on race, gender, sexuality or disability, linguistic disadvantage is far more difficult to recognize. Partly this is due to the fact that Australians who speak English as their first language have fewer and fewer opportunities to learn another language and hence are poorly equipped to relate to the challenges of language learning. As a result, discussions of linguistic diversity are often based on the false premise that individuals exert full control over their linguistic repertoires. In reality, learning a new language while also trying to do things through the medium of that language – to work, to study, to present your symptoms to a nurse – is a double challenge and these two aims of communication are not always compatible.

To mitigate linguistic disadvantage requires both individual and institutional efforts. Individuals need to be prepared to share the communicative burden rather than placing it exclusively on the shoulders of NESB speakers. Institutions need to put in place adequate policies and training opportunities to identify and meet language needs. Switching on to an unfamiliar accent may require extra mental effort and catering to the language development needs of everyone in an institution requires extra resources. However, these investments will pay dividends by contributing to the kind of inclusive and cohesive society we all want to live in.

How language barriers such as these can be bridged will be the focus of tomorrow’s “Bridging Language Barriers” Symposium. We’ll be looking forward to welcoming attendees to Macquarie University but if you cannot attend in person, you can still join the conversation with our team of live-tweeters. Our Twitter hashtag will be #LOTM2017.

ResearchBlogging.org Kenison TC, Madu A, Krupat E, Ticona L, Vargas IM, & Green AR (2017). Through the Veil of Language: Exploring the Hidden Curriculum for the Care of Patients With Limited English Proficiency. Academic medicine : journal of the Association of American Medical Colleges, 92 (1), 92-100 PMID: 27166864

Author Ingrid Piller

Dr Ingrid Piller is Professor of Applied Linguistics at Macquarie University, Sydney, Australia. Ingrid’s research expertise is in the fields of intercultural communication, bilingual education and the sociolinguistics of language learning and multilingualism in the contexts of migration and globalization.

More posts by Ingrid Piller
  • Ha Pham

    it is a sad story when a young man died soon just because of his poor English proficiency. Native speakers should have treated them in a more sympathetic way, giving nonnative people opportunity to express their dire needs especially basic medical care. Why dont native speakers try learn a bit nonnative people’s language so that they can understand what nonnative speakers are endeavoring to get across.

  • Jay Mi Tan

    It is sad but true, that societies are very judgmental. There are so many cases in the world where people are shunt merely because they could not speak the variety of language that are deemed as ‘standard’. The case of Ahmed is indeed an extreme case, which caused his life, and society need to stop being so judgmental/ stereotypical. Just because the variety of language is different, that doesn’t make a human less human. It would be great if linguistic diversity and/or pragmatics could be made a compulsory subject around the world, to make the world a better place.


    Linguistic diversity is common to some societies. In such cases, the intelligibility of using the dominant language have been a great struggle when the dominant language is a L2 or another language. As English is a global or international language, for some societies learning both the language and content are complex. Accents and pronunciations are challenges as L1 accent becomes stronger and thus a conversation with a NS and NNS could be distorted.
    It is a case by case situation. Two different language speakers conversing in English would be less face threatening then with a NS and a NNS. However, for the conversation to be clearer and understandable each participant has the roles of asking for clarification or affirmation. This may be possible depending on the level of proficiency.

  • Bindu pokhrel

    I would call it a ruthless and inhuman act if one really has to pay their life off for their insufficient competency on any languages. Language enables us to express ourselves exactly to the point and limited or no knowledge of so can be a barrier to the effective communication. Different languages are spoken in diverse ways. Not all the languages have the similar ways of expressing emotions. Keeping language proficiency aside, I believe every society or culture in the world equally values love and kindness. While the world is celebrating cultural and linguistic diversities, jugging people on how they pronounce a word is not regarded civilized. Rather then being captious one has accept the people from the parts of the world as they are. Before everything there should exist a humanitarian ground for considering, loving and respecting people.